Injectable Contraceptive May Increase HIV Risk

The common injectable contraceptive, depot-medroxyprogesterone acetate (DMPA), may dramatically increase the risk of HIV infection, according to a new study published by Endocrine Reviews.

DMPA is the most prevalent form of contraceptive in Sub-Saharan Africa, where HIV is widespread. The authors said that transitioning away from DMPA may help protect women from high-risk regions from contracting HIV.

Evidence suggests that this injectable contraceptive may increase the risk of HIV by up to 40%. Interestingly, other forms of contraceptive injections were not found to have the same risks.

In the study, the authors explored the underlying reasons DMPA may increase the risk of HIV while other contraceptives do not.

“To protect individual and public health, it is important to ensure women in areas with high rates of HIV infection have access to affordable contraceptive options,” said first author Janet P. Hapgood, PhD. “Increasing availability of contraceptives that use a different form of the female hormone progestin than the one found in DMPA could help reduce the risk of HIV transmission.”

The investigators reviewed clinical trials and analyzed animal, cell, and biochemical research on medroxprogesterone acetate (MPA), a form of progestin used in DMPA.

The study revealed that MPA acts differently than other progestins used in contraceptives, according to the study. The authors noted that MPA behaves similarly to cortisol in the cells of the genital tract, which can come into contact with HIV.

The authors concluded that other forms of contraceptives should be used in Africa and other high-risk areas in order to effectively combat the HIV/AIDS epidemic.

“The increased rate of HIV infection among women using DMPA contraceptive shots is likely due to multiple reasons, including decreases in immune function and the protective barrier function of the female genital tract,” Dr Hapgood said. “Studying the biology of MPA helps us understand what may be driving the increased rate of HIV infection seen in human research. These findings suggest other forms of birth control should rapidly replace DMPA shots.”